University of Alabama, Birmingham, AL, USA.
Am J Cardiol. 2011 Mar 15;107(6):935-7. doi: 10.1016/j.amjcard.2010.11.012. Epub 2011 Jan 19.
The southeastern region of the United States is known as the "stroke belt" because of excess stroke mortality in this region compared to the rest of the country. However, whether a similar geographic variation in heart failure mortality exists is unknown. Using the Center for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research publicly available compressed mortality data files and 2000 United States population as the standard, we estimated age-adjusted heart failure and stroke mortality rates per 100,000 for patients of all ages, men and women, and all races during 1979 through 1998 in the United States and mapped rates at the state level. Age-adjusted heart failure mortality rate for the 6 contiguous southeastern states (Alabama, Arkansas, Mississippi, Oklahoma, Louisiana, and Georgia) was 31.0/100,000, which was 69% higher than the national rate of 18.3/100,000. This geographic disparity was similar in African-Americans (32.9/100,000 in the southeast vs 21.7/100,000 nationally) and whites (30.8/100,000 in the southeast vs 18.1/100,000 nationally). These findings suggest that, in addition to the stroke belt, the southeastern region of the United States may also be burdened by a "heart failure belt." To better understand the causes of excess stroke mortality in the stroke belt, the National Institutes of Health has funded the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study (n = 30,239, >1/2 from the southeastern region), which provides a unique opportunity to study the underlying causes of excess heart failure mortality in the heart failure belt.
美国东南部地区被称为“中风带”，因为该地区的中风死亡率高于全国其他地区。然而，心力衰竭死亡率是否存在类似的地理差异尚不清楚。利用疾病控制与预防中心广范围在线流行病学研究可用的压缩死亡率数据文件和 2000 年美国人口作为标准，我们估计了 1979 年至 1998 年期间美国所有年龄段、男性和女性以及所有种族的每 10 万人中心力衰竭和中风死亡率，并在州一级绘制了死亡率图。6 个相邻的东南部州（阿拉巴马州、阿肯色州、密西西比州、俄克拉荷马州、路易斯安那州和佐治亚州）的年龄调整后心力衰竭死亡率为 31.0/100,000，比全国 18.3/100,000的比率高出 69%。这种地理差异在非裔美国人（东南部为 32.9/100,000，全国为 21.7/100,000）和白人（东南部为 30.8/100,000，全国为 18.1/100,000）中相似。这些发现表明，除了“中风带”外，美国东南部地区可能还受到“心力衰竭带”的困扰。为了更好地了解中风带中风死亡率过高的原因，美国国立卫生研究院资助了 Reasons for Geographic and Racial Differences in Stroke（REGARDS）研究（n=30239，超过 1/2来自东南部地区），该研究为研究心力衰竭带中心力衰竭死亡率过高的潜在原因提供了独特的机会。
